جستجوی مقالات مرتبط با کلیدواژه "immobilization" در نشریات گروه "پزشکی"

The study focused on the amylase enzyme, widely used in the industrial starch liquefaction process. We looked into the best way to immobilize the native strain Bacillus licheniformis, which is the only alpha-amylase-producing bacterium, by trapping it in calcium alginate gel. This is a promising way to increase enzyme output.

We examined the effects of alginate content, biomass age, initial cell loading (ICL), bead size, and solidification duration in calcium chloride solution on enzyme synthesis. We conducted batch fermentations using both immobilized and free cells.

Alpha-amylase production significantly increased with the alginate concentration ratio, achieving a maximum enzyme yield of 23.5 U/mL at a 30 g/l alginate concentration, utilizing an initial cell loading of 1.5 g in 150-200 beads per flask. These involved cells from a 12-hour culture with a bead size of 5.0 mm, were solidified for 24 hours in a 2.5% (w/v) calcium chloride solution. The yield of the immobilized cells was approximately 111.71% higher than that of the free cells, which produced 11.1 U/ml. The immobilized cells consistently generated alpha-amylase over five repeated cycles, attaining a peak value of 23.5 U/ml during the first cycle, which was 2.2-fold more than the control (free cells).

We used a basic mass balance analysis to understand the growth of both fractions and the dynamics of amylase production in free cells and cells immobilized in Ca-alginate beads. The production of alpha-amylase in immobilized cells results in enhanced volumetric activities during fermentation. Notable advantages of this technique encompass prolonged stability, reuse and recycling, and the potential for adaptable regeneration.

Caregivers face various difficulties that put a huge burden on them, especially when dealing with immobilized elderly patients. This study aimed to compare caregivers’ burdens and coping mechanisms during the care of immobilized elderly patients.

The descriptive comparative design was adopted for this study in Najran City, Saudi Arabia, and Damanhour City, Egypt, in 2022. A total of 104 caregivers were conveniently selected over 3 months of data collection using the following tools: Elderly Patient Caregivers’ Knowledge, Elderly Caregivers’ Practice, The Lazarus Coping Strategies Questionnaire, and Zarit Burden Inventory. The authors used descriptive statistics (mean, frequencies, and standard deviation) and inferential statistics (Chi‑square, t‑test, Pearson correlation, Spearman correlation) to analyze the data.

In Najran, 57.70% of caregivers experienced a mild level of burden compared to 30.80% in Damanhour, indicating a significant difference in the total level of burden between the two groups (X2 = 7.90, df = 2, p = 0.01). The mean coping mechanism score among caregivers in Najran is significantly higher than the mean among caregivers in Damanhour. The duration of providing the care significantly influenced the total level of burden, the total level of practice, the coping mechanism, the income, the availability of health care, and the presence of additional caregivers, with all p values <0.05.

It is essential to integrate nurses and caregivers into educational programs to help them cope effectively with the challenging duties they undertake. Based on the findings of this study, interventional studies to reduce the burden and improve coping among caregivers are recommended.

Proximal humerus fractures (PHFs) are common fractures in the elderly and are typically treated conservatively with immobilization. However, there is no consensus on whether to choose early or late conventional mobilization, taking their outcomes into ac count. This paper reviews comparative studies on the clinical outcomes of one- and three-week immobilization periods in terms of limb function, pain intensity, and complications following the adoption of the non -surgical treatment of PHF.

The current systematic review started with searching PubMed, Scopus, and Web of Science databases for randomized clinical trials (RCTs) on PHF patients to compare the clinical outcomes between patients receiving the one-week mobilization (early mobilization) and those receiving the three-week mobilization (late mobilization). We also performed a meta-analysis to compare the two groups’ limb function and pain levels at three and six months of follow-up.

Five of the seven RCTs had adequate data to be included in the meta-analysis. The quantitative results showed that the early mobilized patients had improved limb function at three [weighted mean difference (WMD): 5.15 (CI 95%: 0.68-9.62)] and six [WMD: 3.51 (CI 95%: 0.43-6.60)] months, but not at 12 months of follow-up. At either three, six, or 12 months, there was no difference in pain intensity between the two groups.

This review supports the adoption of early mobilization at one week for the non-operative management of PHFs. However, to compare the long-term effects, more clinical trials with longer follow-ups are needed. Level of evidence: I

Proper cervical spine immobilization is essential to prevent further injury following trauma. This study aimed to compare the cervical range of motion (ROM) and the immobilization time between traditional spinal immobilization (TSI) and spinal motion restriction (SMR).

This study was a randomized 2x2 crossover design in healthy volunteers. Participants were randomly assigned by Sequential numbered, opaque, sealed envelopes (SNOSE) with permuted block-of-four randomization to TSI or SMR. We used an inertial measurement unit (IMU) sensor to measure the cervical ROM in three dimensions focusing on flexion-extension, rotation, and lateral bending. The immobilization time was recorded by the investigator.

A total of 35 healthy volunteers were enrolled in the study. The SMR method had cervical spine movement lower than the TSI method about 3.18 degrees on ROM in flexion-extension (p < 0.001). The SMR method had cervical spine movement lower than the TSI method about 2.01 degrees on ROM in lateral bending (p = 0.022). The immobilization time for the SMR method was 11.88 seconds longer than for the TSI method (p < 0.001) but not clinically significant.

SMR that used scoop stretcher resulted in significantly less cervical spine movement than immobilization with a TSI that used long spinal board. We recommend implementing the SMR protocol for transporting trauma patients, as minimizing cervical motion may enhance patient outcomes. 

Inadequate spinal motion restriction in patients suffering from spinal injuries could lead to further neuro-logical damage, ultimately worsening their prognosis. This study aimed to investigate the efficacy of long spinal boards(LSB), ske stretcher, and vacuum mattress for cervical spine immobilization during transportation of patients by mea-suring the angular motion of the cervical spine following lifting, transferring, and tilting.

We conducted anexperimental study using a box of three randomizations and crossover designs without a washout period effect for thelong spinal board, sked stretcher, and vacuum mattress. We concealed the randomization with sequentially numbered,opaque, sealed envelopes (SNOSE). Kinematic data were collected using eight optoelectronic cameras at 200 Hz (BTSBioengineering, Milan, Italy) in triangular planes (lateral bending, flexion-extension, and axial rotation) while perform-ing all three motions (static lift-hold, transfer, and 90° tilt).

12 cases (7 males and 5 females) with the mean age of20 ± 3.03 (range: 18-28) years were studied. The three highest angular motions were observed in the axial rotation planeduring patient’s tilting under immobilization on all devices (Vacuum mattress having the highest value of 99.01±8.93,followed by the LSB at 89.89±34.35 and the sked stretcher at 86.30±7.73 degrees). During patient lifting, a higher angularmotion was observed with vacuum mattress immobilization in flexion extension (Coefficient = 4.45; 95%CI: 0.46 – 8.45;p =0.029) and axial rotation (Coefficient = 3.70; 95%CI: 0.58 – 6.81; p =0.020) planes. During patient transfer, a higher an-gular motion was observed with sked stretcher in the flexion-extension plane (Coefficient = 2.98; 95%CI: 0.11 – 5.84; p =0.042). During patient tilting to 90 degrees, a higher angular motion was observed with vacuum mattress immobilizationin lateral bending (Coefficient = -4.08; 95%CI: -7.68 - -0.48; p = 0.026) for the vacuum mattress.

Based onthe finding of the present study, patients on the vacuum mattress experience significantly higher angular motion in flex-ion extension and axial rotation during lifting, as well as lateral bending during 90-degree tilting. In addition, patientson the Sked stretcher showed significantly higher angular motion in flexion-extension during the transferring. However,the predictive margins for immobilization across all devices did not demonstrate clinically significant differences amongthe three immobilization devices.

Different countries have used different methods to reduce trauma-related mortality and its complications.

Splint is a temporary and conventional method of fixing an injured organ. Therefore, evaluating the quality of life in trauma patients with splint immobilization is important.

This prospective study was performed on 287 trauma patients with splint immobilization in two baseline periods and one month later in Haft-e-Tir and Rasoul-e-Akram hospitals. The Data collection tool was the SF-36 quality of life questionnaire. Paired t-test was used to assess the changes in the quality of life. SPSS version 21 was used for statistical analysis.

The mean quality of life in the study’s first phase was 76.31 ± 9.42, and one month after splint immobilization was 76.13 ± 8.98, and there was no significant difference between the two phases. The Splint immobilization of the patients significantly affected the quality of life in 5 out of 8 dimensions. Still, the intervention increased the scores in 3 dimensions and decreased scores in 2 dimensions. The results showed that social performance (P = 0.01), energy and vitality (P < 0.001), and emotional health (P < 0.001) increased, and physical performance (P = 0.01) and general health (P = 0.001) decreased, and they were significantly different in the two phases. There were no significant differences between emotional limitation, physical limitation, and pain in the two phases of the study.

Splint immobilization of patients improved the quality of life in 5 out of 8 dimensions. After a month, the trauma-related mental and physical shock did not disappear, and even the patients were more sensitive to quality-of-life questions due to time spent with splint immobilization and familiarity with its limitations. The patients tried to reflect on their dissatisfaction with splint immobilization.

Alpha-amylase is one of the most widely used enzymes in the starch industry. However, industrial application of soluble alpha-amylase is hampered by changes in pH and temperature (adverse effects on enzyme stability) and activity loss, leading to higher costs. Immobilization of alpha-amylase is an efficient strategy to reduce the enzyme losing and subsequently reduces costs in this regard. Alpha-amylases are immobilized by adsorption, entrapment, covalent attachment, and cross-linking. A barrier in alpha-amylase immobilization is the large size of its substrate, namely amylose and amylopectin. Most of these immobilization methods decrease the affinity of the enzyme for its substrate as well as the maximum rate of reaction (Vmax). This review aims to study different aspects of alpha-amylase including enzyme activity, applications, structure, starch, immobilization methods, and immobilization’s obstacles to improve alpha-amylase efficiency in the industry and also lowering the costs related to providing this enzyme.

There is no clear consensus on the best treatment option for scaphoid fractures. 

In this study, we aim to evaluate the short-term clinical and radiologic outcomes in patients with acute isolated scaphoid fractures treated with surgical or nonsurgical methods.

In a retrospective study, 31 patients with acute isolated scaphoid fracture (Mean±SD age: ‎28.9±9.9 ‎years) treated with open reduction and internal fixation (n=15) or cast immobilization (n=16) methods were included. The fractures were classified according to Herbert & Fishers’ classification system. Clinical outcome measures were the wrist range of motion, pinch strength, and grip strength. Radiographic outcome measures were the lunocapitate angle, scapholunate angle, and ulnar variance. The outcome were compared between the involved and uninvolved hands and between surgical or nonsurgical groups.

The majority of fractures were type B2 (n=14). In a Mean±SD follow-up of 15.1±3.2‎‏ months, the mean extension, flexion, pinch, and grip strength of the involved hand averaged 81.3%, 80.7%, 90%, and 87% of the uninvolved hand. Accordingly, clinical outcomes were significantly lower in the involved hand. The scapholunate angle was significantly higher in the involved hand (P=0.002). Clinical and radiographic outcomes were not significantly different between the surgical and nonsurgical groups. Radiographic malalignment was detected in 25 scaphoids. No significant correlation was found between the clinical and radiographic outcomes.

After scaphoid fracture union, the decrease in wrist range of motion (extension, flexion) and grip/pinch strength has no correlation with radiographic results.

Immobilization is an approach in industry to improve stability and reusability of urease. The efficiency of this technique depends on the type of membrane and the method of stabilization.

The PEI-modified egg shell membrane was used to immobilize urease by absorption and glutaraldehyde cross-linking methods. The membranes were characterized by Fourier-transform infrared spectroscopy (FTIR) and AFM, and Nessler method was applied to measure the kinetic of the immobilized enzymes. Finally, the storage stability (6 °C for 21 days) and reusability (until enzyme activity reached to zero) of the immobilized enzymes were investigated.  

Based on FTIR, three new peaks were observed in both the absorption- (at 1389.7, 1230.8, and 1074.2 cm-1) and the cross-linking (at 1615-1690, 1392.7, 1450 cm-1) immobilized enzymes. The surface roughness of the native membrane was altered after PEI treatment and enzyme immobilization. The optimal pH of cross-linking immobilized enzymes was shifted to a more neutral pH, while it was alkaline in adsorption-immobilized and free enzymes. The reaction time decreased in all immobilized enzymes (100 min for free enzyme vs. 60 and 30 min after immobilizing by adsorption and cross-linking methods, respectively). The optimal temperature for all enzymes was 70 °C and they had a higher Km and a lower Vmax than free enzyme. The stability and reusability of urease were improved by both methods.

Our findings propose these approaches as promising ways to enhance the urease efficiency for its applications in industries and medicines.

Pectinase or pectinolyticenzyme is a complex enzyme with different catalytic units including polygalacturonase, pectin esterase and pectin lyase to degrade pectin polymers into different end products. The pectinase with degrading capability of pectin can be utilized in various industrial applications, such as clarification of fruits and vegetable juices, degumming of plant bast fibers, textile industries for removing non-cellulosic impurities, papermaking industries, wine clarification, coffee and tea fermentation, wastewater treatment, as well as, it is also used for the isolation of protoplasm in plant science research. Pectin derived oligosaccharides (POS) produced by pectinase are considered as prebiotic molecules. However, the low operational stability in harsh industrial conditions confines the utilization of pectinase in industrial processes. Immobilization is the technique, which not only enhanced the stability of pectinase, but also, made the enzyme reusable for continuous industrial processes. The current review shares information about the pectinase and how the immobilization technology can enhance the industrial application of pectinase. Furthermore, various supports such as sodium alginate, agar-agar, polyacrylamide, aminated silica gel, nanocomposite microspheres, silica coated chitosan, nylon-6, porous glass etc. have been tested for the immobilization of pectinase through different methods, including entrapment, binding to a support and enzyme crosslinking.

Pre-hospital intubationis a challenging but essential intervention. During intubation, it is difficult to identify vocal cords when using a cervical collar and trauma board. Therefore, the success rate of intubation by paramedics decreases in trauma patients. Video laryngoscopyincreases intubation success rate and has been recommended for difficult airways in studies.

In this study, we compared the intubation success rates when using a video laryngoscope and a direct laryngoscope in a manikin with simulated cervical immobilization.

In this cross-sectional study, the manikin’s neck collar and spine board created a complicated airway model with cervical immobilization. Inexperienced paramedic students tried intubation with both methods, and their trial periods were recorded. Students answered a question evaluating the convenience of the procedure for both methods after the trial.

In this study, 83 volunteers, who were first-year and second-year paramedics, participated;32 (38.6%) of the volunteers were first-year students, while 51 (61.4%) were second-year students. All volunteers had previous intubation experience with direct laryngoscopy, but not with video laryngoscopy. There was a statistically significant difference in the first-attempt success rates of the procedure between the groups in favor of video laryngoscope (p=0.022). Note that there was no significant difference between the groups in terms of first attempt durations (p=0.337).

Video laryngoscopy in airway management can increase the success rate of first-attempt intubation by inexperienced pre-hospital healthcare personnel.

Drill Cutting (DC) are large amount of waste generated in gas and oil exploration and production activities that contains toxic substances, especially heavy metals. This study aimed to use Conocarpus Waste (CW) biochar to investigate its effects on changes in chemical forms and stabilization and distribution of Cu and Zn in DC samples of Ahvaz oil field at different incubation times. In order to study the effects of CW biochar at different rates (0, 2, 5, and 10% w/w) and four incubation times (1, 2, 4, and 8 weeks) for adsorption and chemical fractionation of Copper (Cu) and Zinc (Zn) in DC of Ahvaz oil field in southwestern Iran. An experiment was conducted as a factorial in a completely randomized designing in three replication. Sequential extraction procedure of Tessier was applied for the determination of heavy metals fraction. Application of biochar significantly (p <0.05) increased the pH, soil organic carbon (SOC), electrical conductivity (EC), and cation exchange capacity (CEC) especially at the 10% application rate. After the addition of CW biochar, the exchangeable (EX) and carbonate (CAR) fractions of Cu and Zn, respectively decreased (P≤0.05) significantly while organic matter (OM) bound, oxides (OX) bound, and residual (RES) fraction were increased. The CW biochar can be a low-cost and effective amendment in immobilizing the Cu and Zn, and also effectively to reducing their mobility in DC.

The incidence of Venous Thromboembolism (VTE) and its prophylaxis in patients with an ankle injury and cast immobilization are controversial.

This study aimed to investigate the effect of aspirin and enoxaparin on VTE prevention in patients with an ankle sprain and cast immobilization.

In a double-blind, randomized clinical trial, 90 eligible patients were divided into three groups: patients who did not receive the drugs (the control group), patients who received aspirin (325 mg/d) for 3 weeks (the ASA group), and patients who received enoxaparin (40 mg/d subcutaneously) for 3 weeks (the enoxaparin group). After 3 weeks, the plaster was opened, and the D-dimer level was measured if there was a VTE symptom during the study. Otherwise, at the end of the study, the bilateral lower-limb Complete Compression Ultrasonography (CCUS) and color Doppler ultrasound were used to image the lower limb venous system.

Sixty-eight patients completed the study. The mean±SD values of D-dimer in the control, ASA, and enoxaparin groups were 0.33 (0.47) μg/dL (Median=0.18 μg/dL), 0.32 (0.14) μg/dL (Median=0.3 μg/dL) and 0.32 (0.25) μg/dL (Median=0.21 μg/dL), respectively (P>0.05). The positive D-dimer was seen in 2 patients (8%) of the control group, 2 patients (8.3%) of the ASA group, and 2 patients (10.5%) of the enoxaparin group (P>0.05). The color Doppler ultrasound was negative in all patients.

Because none of the 68 patients in the current study developed VTE during our 30 days follow-up period, it seems that prophylaxis treatment is unnecessary in patients with an ankle sprain and cast immobilization. Further studies on more patients with a longer period of follow-up are recommended.

3D printing is an evolving technology which has a potential application in the treatment pediatric forearm fractures. Verylittle has been published with regard to 3D casting in children. We present two cases in which upper extremity fractures inpediatric patients were treated by wearing a custom made 3D printed cast. At latest follow-up at least one year post-injury,the clinical outcomes were excellent.Orthopaedic surgeons may benefit from familiarizing themselves with the potential of 3D printing technology and utilizingits current applications, as well as devising future applications, in clinical practice.Level of evidence: IV

The aim of this study was to determine the accuracy of two different immobilization methods in patient positioning in cranial radiotherapy. The six-dimensional (6D) target localization accuracy of using a dedicated stereotactic mask was compared with that of a conventional head mask by the ExacTrac system.

A total of 56 patients with cranial lesions were included in this study (26 patients with a dedicated stereotactic mask and 30 subjects with a conventional head mask). The ExacTrac image-guided positioning system was utilized to obtain daily translational and rotational patient positioning displacement from the intended position. The 6D setup data was analyzed to obtain population mean, systematic and random errors, and three-dimensional (3D) vector shifts in all the patients.

The population mean values of setup errors were comparable with both immobilization systems; however, the spread as indicated by population systematic and population random errors was more in the use of a conventional head mask. The mean values of the 3D vector shifts were 2.09±1.00 and 4.51±3.38 mm with the use of a dedicated stereotactic mask and conventional head mask, respectively. The frequency distribution of maximum rotational deviation and statistical analysis demonstrated a significant difference in immobilization accuracy between stereotactic immobilization and 3-clamp immobilization (P<0.05).

The results revealed that there was a significant reduction in target positioning errors with a dedicated stereotactic mask, compared to that with a conventional cranial mask. Furthermore, a dedicated stereotactic mask is required to keep rotational deviations within system correctable limits.

Migration and mobilization of recalcitrant organic contaminants such as polycyclic aromatic hydrocarbons (PAHs) in contaminated sites may endanger groundwater resources if considerable amounts of these compounds are mobilized and leached from solid phase into aqueous phase. The aim of the present study was to investigate the influence of biochar in two forms i.e. crushed and pulverized on immobilization and leaching behavior of high molecular weight (HMW) PAHs from contaminated soil into water as well as evaluation of contribution of dissolved organic carbon (DOC) in mobilization and release of HMW PAHs in crushed and pulverized biochar-amended soil, which was addressed for the first time in this study. Column leaching test was used to evaluate the leaching behavior of selected HMW PAHs from soil. Concentrations of PAHs in column leachates were determined using a GC/MS. Findings showed strong sorption of the studied HMW PAHs to solid phase in both unamended and amended columns. Dibenz[a,h]anthracenewas not mobilized by water flow in any of the examined treatments and showed the greatest affinity to solid matrix. Mobility and leaching of most HMW PAHs were enhanced in the presence of crushed biochar. Direct correlation between detected concentrations of HMW PAHs in column percolates and DOC was found in biochar-amended soil. Biochar can be used as a promising cost-effective alternative to activated carbon in immobilization of PAHs in contaminated sites. However, contribution of DOC in mobilization of HMW PAHs from contaminated soils towards groundwater resources cannot be neglected.

Stress contributes to sleep-wake behavior in all animals. It seems that factors such as learning and memory processes can improve sleep disorders. Therefore, the present study was conducted to determine the effects of stress and learning (spatial memory) on total post-stress rapid-eye-movement (REM), non-rapid-eye-movement (NREM) and waking time in rats.

Adult rats (n=21) were divided into 3 groups; group 1 received only immobilization stress; group 2 was subjected only to the learning process (Barnes maze); and group 3 underwent both the stress and learning conditions. For each rat, sleep signals were recorded for 2 hours for 3 consecutive days. After recording of sleep or awakening signals, animal subjected to immobilization stress for 2 hours in each day. Then, post-stress and post-learning signals were recorded for another 2 hours.

Immobilization stress resulted in significant decrease in total REM sleep time. However, total time of NREM increased following stress. Performing the learning task resulted in a significant increase in post-learning REM time (P<0.05). Moreover, total NREM time did not change markedly following the learning process. Interestingly, the learning process significantly (P<0.05) decreased total time of awakening when compared with pre-learning condition. However, learning process could increase REM sleep significantly (P<0.05) after the stress condition has been administered. 

Our data suggested that immobilization stress could not prevent REM sleep after a learning process has been administered. However, the completion of a learning process increased post-stress REM time. It seems that learning helps to prevent the inhibitory effects of stress on REM sleep.

Hand and wrist soft tissue injuries are common orthopedic problems that are traditionally treated with short arm splint, which covers the forearm to 1 cm distal to the elbow crease. The present study was conducted to compare the treatment efficacy of traditional standard-size splint with half-length short arm splint. In this randomized, controlled, clinical trial, patients with hand and wrist soft tissue injuries were randomly assigned to two groups. Group one received standard-sized short arm splints and the other group received half-length short arm splints. The swelling and pain scores were compared between the groups by the end of weeks one, two and three. A total of 256 patients with a mean age of 36.96 ± 12.27 years were enrolled in this study, and 71.9% of them were male. No statistically significant differences were observed in terms of swelling between the two groups after one and two weeks (P=0.41, P=0.18). None of the patients had swelling after three weeks. No statistically significant differences were observed between the two groups in terms of the pain score after one, two and three weeks (P=0.47, P=0.29, P=0.92). In this study, half-length short arm splints were found to be as effective as standard short arm splints.